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1679128003
CHARLIE CHAMPION
STANFORD, CA
NPI
1679128003
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-08-02
Last Update Date
2019-08-02
Business Address
CHARLIE CHAMPION
866 CAMPUS DR
STANFORD, CA 94305-8508
Phone number: 209-380-4952
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Mailing Address
CHARLIE CHAMPION
628 STEWART RD
MODESTO, CA 95356-9628
Phone number: 209-380-4952
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